JAMA

Using Brain Activity to Guide Anesthesia May Affect Delirium After Major Surgery in Older Adults

Updated

Abstract

Postoperative delirium occurred in 26.0% of patients receiving EEG-guided anesthesia compared to 23.0% receiving usual care, with a difference of 3.0% (P = .22).

  • EEG-guided anesthetic administration did not significantly reduce the incidence of postoperative delirium within the first five days after surgery.
  • Patients in the EEG-guided group had a lower median end-tidal volatile anesthetic concentration compared to those in the usual care group (0.69 vs 0.80 minimum alveolar concentration).
  • The cumulative time with EEG suppression was significantly less in the guided group (7 minutes) compared to the usual care group (13 minutes).
  • Undesirable movement occurred more frequently in the EEG-guided group (22.3%) than in the usual care group (15.4%).
  • No significant differences were observed in postoperative nausea and vomiting or serious adverse events between the two groups.

Simplified

Full Text

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Funding

Competing interests

Conflict of Interest Disclosures: Dr Wildes reported grants from National Institute on Aging (NIA) during the conduct of the study and grants from National Institutes of Health (NIH) outside the submitted work. Ms Mickle reported grants from NIA during the conduct of the study. Dr Ben Abdallah reported grants from NIA during the conduct of the study. Ms Maybrier reported grants from NIA during the conduct of the study. Mr Oberhaus reported grants from NIA during the conduct of the study. Dr Budelier reported grants from NIA during the conduct of the study. Mr Kronzer reported grants from the Agency for Healthcare Research and Quality and the National Science Foundation outside the submitted work. Ms McKinnon reported grants from NIA during the conduct of the study and grants from the Agency for Healthcare Research and Quality and the National Science Foundation outside the submitted work. Mr Park reported grants from NIA during the conduct of the study. Dr Palanca reported grants from NIA outside the submitted work during the conduct of the study. Dr Goswami reported grants from the National Science Foundation outside the submitted work. Dr Jordan reports grants from NIA and NIH during the conduct of the study. Dr Lin reported grants from NIA during the conduct of the study. Dr Fritz reported grants from NIH outside the submitted work during the conduct of the study. Dr Jacobsohn reported grants from Canadian Institutes of Health Research outside the submitted work during the conduct of the study. Dr Schmitt reported grants from NIA during the conduct of the study. Dr Inouye reported grants from NIA during the conduct of the study. Dr Stark reported grants from NIA during the conduct of the study. Dr Lenze reported grants from NIA, grants from NIH, grants from FDA and grants from PCORI, personal fees from Takeda, personal fees and nonfinancial support from Alkermes, personal fees from Aptinyx, personal fees and nonfinancial support from Janssen, personal fees from Barnes Jewish Foundation, personal fees from Taylor Family Institute for Innovative Psychiatric Research, personal fees from Lundbeck, and personal fees from McKnight Brain Research Foundation outside the submitted work. Dr Avidan reported grants from NIA and funds from the Dr Seymour and Rose T. Brown Endowed Professorship during the conduct of this study, and grants from other NIH institutes, the Agency for Healthcare Research and Quality, the National Science Foundation, the McDonnell Foundation for Neuroscience, and the Canadian Institutes of Health Research outside the submitted work. No other disclosures were reported.
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